Florida Worker's Comp vs LTD - Need advise

[steelersgurl]

I live in the state of Florida. In the beginning of 2009, I had some ongoing issues with my hand and elbow. An initial MRI showed no damage to the elbow. A few weeks later, I noticed severe pain while at work and went to the company's health facility. The Doctor examined me and gave me the paperwork to give to my supervisor and safety manager. On the same day, I met with my safety manager to give her a copy of the health facility paperwork. At that time, she indicated that I could just file for STD. In March of 2009, I had orthoscopic surgery on my elbow as well as carpal tunnel surgery on the same extremity. During the procedure, the doctor indicated that I had a completely torn off ligament, in my elbow, and thus had to open my arm and reconstruct the elbow. I was approved for STD for 3 months and was then approved for LTD. I have been on LTD for seven months now and approved for 24 months.

The insurance company had asked me to file a WC claim. I contacted the safety manager again and she indicated that too much time had passed and I would never get approved for WC. I emailed her - again - the form that the health facility completed and reminded her that we had met on the very same day that I was injured. I also have proof of the emails, on that day, indicating my injury to all upper management employees (it's the company policy to file a "close call" for injuries which establishes emails to all management). She never called me back and has refused to answer my emails. I contacted the HR department and they too have not answered my calls or emails. I sent certified letters requesting the WC, STD and LTD policies and have not received an answer. It is my belief that the safety manager "dropped the ball" and never filed the WC claim. My insurance company is now trying to collect on WC themselves since, they too, cannot gain information from the company. As a note, the company's STD and LTD has changed to a different holder as of October 1st of last year. I am being paid by the previous policy holder. The insurance company calls me several times a month asking about my return to work and constantly wanting information - yet they approved my LTD for 24 months. It's annoying since they have access to my records. I just continue to tell them the same thing with each call.

If a WC claim is approved, would I receive the last year of weekly pay at a different rate as well as having my doctor bills, etc paid for? My STD and LTD has been paid at 60% and I am currently totally disabled from doing my previous job. I am unable to straighten my arm and may need additional surgery. The company has dropped my medical insurance, so I would be unable to afford surgery. Can the LTD company refuse to pay me because I cannot get surgery without medical? Could the company's WC just pay out in a settlement and/or can the LTD company pay out in a settlement?

[1171]

you need to contact the workers comp carrier directly and file a claim.
temporary disability payments for workers compensation are paid at 2/3.
more information on florida's work comp system here
http://www.myfloridacfo.com/wc/

you may need legal help if the comp carrier denies your claim
contact your local bar association for a referal
http://www.abanet.org/barserv/map/fl.html

[steelersgurl]

1171 Wrote:you need to contact the workers comp carrier directly and file a claim.
temporary disability payments for workers compensation are paid at 2/3.
more information on florida's work comp system here
http://www.myfloridacfo.com/wc/

you may need legal help if the comp carrier denies your claim
contact your local bar association for a referal
http://www.abanet.org/barserv/map/fl.html

Thanks for the info. I contacted Florida W/C and they stated that the company needs to file the claim. The company has not responded to my request for the W/C carrier information. They're idiots!

[Bad Boy Bad Boy]

Then get an Attorney working on this, if you can't get it done... A year is way too long now...

[1171]

"My employer will not report my work-related injury or illness to their insurance carrier. What can I do?
Your employer should have the workers' compensation insurance information posted in the workplace. If so, you may contact the insurance carrier and report the claim yourself. If your employer does not have the insurance information posted, you may contact the Employee Assistance and Ombudsman Office for assistance with obtaining that information.
You may contact the Employee Assistance and Ombudsman Office at 1-800-342-1741 or by email at wceao@myfloridacfo.com."
http://www.myfloridacfo.com/wc/employee/...claim.html

you should report the carrier's behavior to the ombudsman and file a complaint with the state insurance regulator.
they are required by law to accept a report of injury from the injured worker.
http://www.myfloridacfo.com/Consumers/needourhelp.htm

[ace25]

1171, I am curious. Why are you sicking her on the carrier? What did they do wrong? As I read it, the carrier asked her to file a claim. Some moron at the state apparently told her that the employer needs to do that.

It appears to me that the employer is the problem here. What carrier behavior should she report?

Inquiring minds want to know.....

[1171]

I assume "W/C" is workcomp Carrier.
but from the her last post it's possible she did not contact the comp carrier.
could be a misreading.

[steelersgurl]

I actually contacted the State of Florida worker's compensation line. They indicated that they needed information from the compan - or maybe they meant the company's w/c carrier. In either case, I can't get the information from the company. They had the information on the day the incident happened, yet failed to file the claim. They told me to just file short term disability. Now STD/LTD wants to go after the worker's compensation carrier to recupe their possible losses.

My question was, if the STD carrier is successful, am I entitled to the worker's compensation percentile rate - which would be higher than the STD/LTD that I have been on for a year.